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double lumen patency for preventing CRBSI

I need some good articles to show our surgeons that we need to keep both lumens of central lines patent in order to prevent any infections. One of our surgeons have been refusing to order tPA when one of the lumens gets clotted as long as other lumen is patent. He believes that the clot is contained to one lumen as these ports of doulbe lumen central lines are all staggered. I would like to argue that it still predisposes to possible infection.

Toshi Holland NP, Vascular Access Program Coordinator

Children's Hospital & Research Center Oakland

I don't think you will

I don't think you will locate any studies that have evaluated the risk of CRBSI when one lumen has been allowed to remain clotted vs being opened with a lytic agent. However, there is an established connection between fibrin/thrombus and biofilm. The best information about this can be found in a presentation by Marcia Ryder at the recent AVA conference. She and Dr. Nifong did a point-counterpoint about thrombus and infection. I am sure you can order the presentation from the AVA website. 

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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